A root canal infection is a serious dental condition that occurs when bacteria has invaded the soft tissue in the center of your tooth, called dental pulp. The condition can cause severe pain and discomfort and it likely happens due to untreated tooth decay or trauma. The good news is that a root canal is a safe and common procedure if you are experiencing root canal infection. It is critical to seek immediate treatment from your dentist since the infection can spread quickly once the bacteria get into the inner parts of the tooth structure. Read on to know how to recognize the warning signs of a root canal infection, the complications, what causes it, and how a dentist treats the condition.

What are root canal infections?

Teeth are made up of two hard layers and soft tissues inside. The outermost and hardest surface is enamel. The dentin is the inner and porous layer which is softer than enamel. Right beneath the dentin lies the pulp, the soft and innermost structure of your tooth.

The pulp contains blood vessels, nerves, connective tissues, and odontoblasts. This mass of tissue allows the tooth to grow when it is developing and to keep it healthy.

If you are experiencing tooth decay, large cavities, and other dental injuries like cracked tooth, it can allow the bacteria to reach the pulp, causing an infection. Therefore, a root canal, also called endodontic treatment, is necessary to remove the pulp if it has been infected or damaged. This will salvage the tooth and prevent further complications like dental abscess.

Root canal is an effective and safe treatment which are successful in most cases. Although root canal infection does not happen often, there is still a small chance that the tooth will become reinfected even after a root canal treatment is done. This may happen due to an incorrect root canal procedure or other reasons.

What are the symptoms of root canal infection?

It is normal if you feel minor pain and discomfort for a few days after a root canal procedure. The nerves may still be inflamed surrounding the affected tooth, so you may have mild pain for a week after. The discomfort may especially rise when eating or if the area around the tooth is under pressure.

However, if you feel severe pain for more than one week after the treatment or if it is getting worse, this is not a normal sign. You should see your dentist as soon as possible as this means there is a root canal infection coming back.

Warning signs to visit the dentist     

There are some signs and symptoms of root canal infection that require visiting a dentist in time. So, be sure to make another dental appointment if you have:

  • Pain or discomfort that can be mild or severe and intensify especially when chewing or placing pressure on the affected tooth
  • Teeth sensitivity in the tooth when you eat hot or cold foods and drinks
  • Swelling and redness in the gums and other soft tissues nearby the affected tooth. You may experience swollen face and neck depending on the severity of inflammation and discomfort.
  • Pain and tenderness in the inflamed gums and surrounding tissues. It can be felt when you press and touch it.
  • Formation of dental abscess (pocket of pus) around the tooth root, causing severe pain and bad breath. It may appear as red pimple on the gums or large bump, where the dental abscess is located.
  • Having bad breath and bad taste in your mouth which is the result of the infection in the tooth or other tissues and seems to be chronic and persistent
  • Tooth darkening which occurs as the bacteria has reached the pulp and has spread. This changes the tooth color into brown and yellowish or dark brown.

What causes root canal infections?

There are various reasons for a tooth to get an infection after a root canal treatment. This may be due to:

  • The delay in the placement of crown, damage to the permanent restoration, or improper sealing of the tooth can allow the bacteria to back into the pulp, leading to infection again.
  • Some areas of the root canals were not fully and properly cleaned and disinfected because of the curvedness or very narrow shape of the root systems.
  • The root canal shapes were so complicated that some areas for disinfection went missing during the procedure.
  • There can be extra accessory canals in your tooth which may have housed bacteria, causing the tooth to reinfect.
  • The tooth can be at risk of root canal infection with cavities forming again or if it is cracked, chipped, or damaged which leaves the pulp exposed.

Can a root canal infection spread to the gums or other teeth?

A root canal infection can spread to other parts of the mouth through the surrounding tissues. This can include the gums, the other teeth, and beyond into the face and jaw. Therefore, prompt treatment is key to save the tooth and prevent the infection from spreading.

If a root canal infection is left untreated, it causes serious health risks. The infection can spread to the face, jaw, or even worse into your bloodstream. 

How to treat root canal infection?

After doing the necessary medical examinations, your dentist will perform the root canal retreatment to get your reinfected tooth back to normal condition.

The procedure for retreatment is similar to your first root canal. Here are the steps:

  • Detect the signs and symptoms of infection and necrotic tissues (dead) to check the vitality of the tooth through X-rays.
  • Apply local anesthesia to numb the affected tooth and the area around it.
  • Protect your gums and mouth by placing a protective barrier around the tooth.
  • Drill the tooth enamel or filling on top to get access to the pulp and root canals.
  • Remove the old filler material and clean out the infection and dead tissues.
  • After irrigating and drying out the area, it is filled with the biocompatible filling material called gutta-percha.
  • The tooth is then sealed with composite or amalgam filling materials to protect it from infection until it heals for crown placement.
  • Your dentist will prepare the tooth and places a permanent crown which restores the optimal shape and function of the tooth.


If you notice any signs of infection after your root canal procedure, see your dentist immediately to get it treated as soon as possible.

The longer time you leave the root canal infection untreated, the more it spreads and more serious the complications. Remember that root canal infections are possible although they are not very common.

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